노인인구에서 인지기능과 혈청지질농도의 연관성
A Correlation between Neurocognitive Function and Serum Lipid Levels among the Korean Elderly
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초록
본 연구에서는 기존의 연구에서와 마찬가지로 고연령, 낮은 교육정도, 당뇨병의 병력, 두부외상의 기왕력, 뇌혈관질환의 기왕력, 하친스키 허혈 점수 등이 알츠하이머형 치매의 독립 위험인자로 평가되었다. 비인지장애군 경도인지장애군 알츠하이머형 치매군 사이에 혈청지질농도의 유의한 차이는 없었다. 경도인지장애군에서 일부 혈청 지질농도가 MMSE-KC 총점수와 특히 MMSE-KC의 지남력에서 음의 상관관계를 보였다. 이는 혈관성위험인자 중 하나인 혈청지질농도가 인지기능 저하의 위험을 높이는 것으로 나타났다. 알츠하이머형 치매군에서는 혈청지질농도와 인지기능과의 상관관계가 드러나지 않는 것은 치매로 완전히 이행된 이후에는 영향이 줄어든 것으로 보인다. 본 연구결과에서는 노인인구의 경도인지장애군의 진단과 조기감별이 중요하다는 것을 시사하고 혈청지질농도의 정기적 검사가 필요하다는 것을 보여준다. 아울러 생활 양식의 개선과 적절한 약물치료로 노인인구 특히 경도인지장애군에서의 혈청지질농도의 조절이 인지기능개선에 도움을 줄 것으로 보인다. 향후 본 연구의 제한점을 보완하여 혈청지질농도와 인지기능의 연관성에 대한 보다 자세한 연구가 필요할 것으로 보인다.
Abstract
Objectives: In this study, we evaluated the correlation between neurocognitive function and serum lipids levels among Koreans over 60 years old. Also, we investigated the sociodemographic risk factors and vascular risk factors in Alzheimer’s disease. Methods: Six hundred fifty elderly persons participated in this study. We screened for cognitive impairment via the Mini-Mental Status Examination-Korean version (MMSE-KC) and evaluated 181 participants using the Consortium to Establish a Registry for Alzheimer’s disease, Korean version (CERAD-K). For further classification, we employed the Clinical Dementia Rating Scale (CDRS) and DSM-IV diagnostic criteria. Participants having a CDRS score of 1 or more were diagnosed as having Alzheimer’s disease. ResultsZZWe diagnosed 38 participants as having Alzheimer’s disease, 67 participants as having mild cognitive impairment, and 76 participants as having no cognitive impairment. There were significant differences among the groups with regard to age, education, history of diabetes mellitus medication, history of head trauma, history of CVA, and Hachinski ischemic score (p<0.05). The mild cognitive impairment group showed inverse correlations between triglyceride serum level and both total MMSE-KC score and Orientation in MMSE-KC (rs=-0.267, p=0.029;rs=-0.324, p=0.007). This group also showed inverse correlations between total cholesterol serum level and both total MMSE-KC score and Orientation in MMSE-KC (rs=-0.259, p=0.034;rs=-0.417, p=0.000) and an inverse correlation between low density lipoprotein serum level and Orientation in MMSE-KC (rs= -0.320, p=0.008). Conclusion: There were inverse correlations between some lipids' serum levels and cognitive functions in the mild cognitive impairment group.
참고문헌 (30)
- "The estimation of Dementia in Korea. The ministry of health and welfare", ~ (2007)
- Shin MK, "A study of follow up treatment state in senile psychiartic patients", J Korean Neuropsychiatry Assoc, 34, pp.663~671 (1995)
- Gao S, "The relationships between age, sex, and the incidence of dementia and Alzheimer's disease: a meta analysis", Arch Gen Psychiatry, 55, pp.809~815 (1998)
- Huh K, "Recognition and diagnosis of dementia", Korean J Psychopharmacol, 3, pp.27~32 (1992)
- Suh GH, "Prevalence and risk factors of dementia and depression in the elderly", J Korean Neuropsychiatry Assoc, 39, pp.809~824 (2000)
- Park JH, "causes & management of dementia", Korean J psychopharmacol, 3, pp.33~42 (1992)
- 양동원, "Korean Dementia Screeing Questionnaire (KDSQ)의 개발과 타당도 및 신뢰도의 평가", 대한신경과학회지, 20(2), pp.135~141 (2002), 대한신경과학회
- Ott A, "Prevalence of Alzheimer's disease and vascular dementia: association with education. The Rotterdam study", BMJ, 310, pp.970~973 (1995)
- Akomolafe A, "Diabetes mellitus and risk of developing Alzheimer disease: results from the Framingham Study", Arch neurol, 63, pp.1551~1555 (2006)
- Razay G, "The Metabolic Syndrome and Alzheimer Disease", Arch Neurol, 64, pp.93~96 (2007)
- 신일선, "광주광역시에서 치매의 유병률과 위험인자의 도시-농촌 지역 비교", 신경정신의학, 41(6), pp.1165~1173 (2002), 대한신경정신의학회
- Reuben DB, "The predictive value of combined hypoalbuminemia and hypocholesterolemia in high functioning community-dwelling older", J Am Geriatr Soc, 47, pp.402~406 (1999)
- 유영선, "노인 인구에서 신경인지기능저하와 혈청 지질농도와의 상관성", 신경정신의학, 47(6), pp.540~547 (2008), 대한신경정신의학회
- Solomon A, "Serum cholesterol changes after midlife and late-life cognition: twenty-one-year follow-up study", Neurology, 68, pp.751~756 (2007)
- 홍창형, "노인인구에서 대사증후군과 인지기능간의 연관성", 신경정신의학, 45(4), pp.349~356 (2006), 대한신경정신의학회
- Obadia Y, "The PREMAP Study: prevalence and risk factors of dementia and clinically diagnosed Alzheimer's disease in Provence, France: Prevalence of Alzheimer's Disease in Provence", Eur J Epidemiol, 13, pp.247~253 (1997)
- Stern Y, "Influence of education and occupation on the incidence of Alzheimer's disease", JAMA, 271, pp.1004~1010 (1994)
- Mortimer JA, "Do psychosocial risk factors contribute to Alzheimer's disease?. in: Etiology of Dementia of Alzheimer type", pp.32~52 (1998)
- Caamaño-Isorna F, "Education and dementia: a meta-analytic study", Neuroepidemiology, 26, pp.226~232 (2006)
- Almeida OP, "Smoking as a risk factor for Alzheimer's disease: contrasting evidence from a systematic review of case-control and cohort studies", Addiction, 97, pp.15~28 (2002)
- Kivipelto M, "Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease", Arch Nerol, 62, pp.1556~1560 (2005)
- Kryscio RJ, "Risk factors for transitions from normal to mild cognitive impairment and dementia", Neurology, 66, pp.828~832 (2006)
- Eckert GP, "Cholesterol modulates the membrane disordering effects of beta-amyloid peptides in the hippocampus: specific changes in Alzheimer's disease", Dement Geriatr Cogn Disord, 11, pp.181~186 (2000)
- Hixson JE, "PDAY Research group. Apolipoprotein E polymorphism affect atherosclerosis in young males", Arteriosclerosis & thrombosis, 11, pp.1237~1244 (1991)
- Jarvik GP, "Interations of apolipoprotein E genotype, total cholesterol level, age, and sex in prediction of Alzheimer's disease: a casecontrol study", Neurology, 45, pp.1092~1096 (1995)
- Bernard F, "Contributions of frontal and medial temporal regions to verbal episodic memory: a PET study", Neuroreport, 12, pp.1737~1741 (2001)
- Poldrack A, "Functional anatomy of long-term memory", J of Clinical Neurophysiology, 14, pp.294~310 (1997)
- Kivipelto M, "Midlife vascular risk factors and late-life mild cognitive impairment: a population-based study", Neurology, 56, pp.1683~1689 (2001)
- Yaffe K, "Serum lipoprotein levels, statin use, and cognitive function in older women", Arch Neurol, 59, pp.378~384 (2002)
- 임준성, "경도인지장애의 아형 분류와 임상 양상", 대한신경과학회지, 23(3), pp.348~355 (2005), 대한신경과학회
